Oral Presentations

Introduction:
Anthrax is the highest priority zoonotic disease in Kenya. Early detection, timely reporting, and rapid response are essential for effective disease management. Despite the Country experiencing more than ten outbreaks annually, published information on the National disease burden remains limited. This study characterized reported anthrax cases in Kenya from January 2014 to December 2023.

Methods:
A retrospective analysis of passive surveillance records of anthrax was conducted. Animal anthrax cases were obtained from the Kenya Animal Bio-Surveillance System (KABS), and human cases from the Kenya Health Information System (KHIS2), covering January 2016 to December 2023. Additionally, outbreak investigation line lists(January 2016 to March 2024) were reviewed to capture demographic and clinical variables. Data analysis was conducted using Epi Info. Descriptive statistics were generated, including frequencies and proportions and measures of central tendency and dispersion. 

Results:
Total of 674 animal cases and 1,168 human cases were reported, with 672 detailed records analyzed. Animal cases peaked in 2021 (24%), largely in Bomet County, while human cases peaked in 2023 (43%), predominantly in Embu County, suggesting linked but distinct hotspots. Cattle accounted for most animal cases (89.7%), with only 34% reportedly vaccinated, majority occurring in extensive production systems (67.6%). Human cases had mean age of 27.8 years (SD ±19.1). Clinical diagnosis predominated in both animal (66%) and human (99%) cases, indicating limited laboratory confirmation. Farmers (30.7%), students (21.4%), and housewives (12.5%) were most affected, highlighting occupational and household exposure , while meat handlers (9.4%) reflect risks along the food chain.

Conclusion:
Anthrax transmission remains active within established high-risk areas, reinforcing the need for a strengthened One Health approach. Targeted livestock vaccination, particularly in extensive production systems, is crucial. However, lack of laboratory confirmation limits accurate estimation of disease burden, underscoring the need for increased investment in diagnostic capacity and outbreak response systems

Introduction
Chikungunya virus (CHIKV) is an epidemic-prone arbovirus in sub-Saharan Africa, yet pregnancy-specific evidence remains limited and largely derived from outbreak-based or retrospective studies. Its contribution to adverse birth outcomes and its role in maternal surveillance systems remain insufficiently defined despite ongoing transmission in diverse settings.

Aim
The study aimed to determine the burden of CHIKV infection during pregnancy and its association with adverse maternal and infant outcomes, and to inform integration of arboviral surveillance into maternal health and epidemic preparedness frameworks in Western Kenya.

Methods
A prospective cohort study was conducted within the PRISMA maternal and newborn health platform. Pregnant women were enrolled before 20 weeks’ gestation from rural Karemo and peri-urban Manyatta sites and followed through delivery and 12 months postpartum. Sites were selected to capture heterogeneous transmission settings, and analyses adjusted for residence to account for contextual differences in exposure and healthcare access. CHIKV exposure was assessed using IgM/IgG serology and PCR. Outcomes included preterm birth, low birth weight (

Background:  Migori County, positioned along the Kenya-Tanzania border, is a known cholera hotspot. In February 2025, the county recorded a surge in acute watery diarrhoea cases testing positive on cholera rapid diagnostic tests, including one death. An immediate investigation was conducted to identify the source, provide clinical care, and contain the outbreak.

Methods: We conducted a descriptive outbreak investigation from February 11th to April 4th, 2025, covering four affected sub-counties: Kuria East, Kuria West, Suna East, and Suna West. Cases were identified using a standardized three-tiered case definition (suspected, probable, confirmed). The investigation collected data through: active case finding, medical record reviews, contact tracing, environmental assessments of affected households, and water sampling from suspected contaminated sources. Laboratory confirmation was achieved through stool culture. Environmental samples underwent analysis using the Most Probable Number (MPN) method for coliform enumeration.

Results: A total of 53 suspected cases, including one death (case fatality rate: 1.9%), were identified. Of 48 cases tested by rapid diagnostic test, 41 were positive; 26 specimens were cultured, confirming V. cholerae O1 serotype Ogawa in 15 (57.6%). Most cases were male (60.4%;n=53), with a median age of 38 years. Kuria East recorded the highest attack rate (2.0/10,000). Farmers (30.8%) ware the most affected group. All isolates were resistant to azithromycin and sulfamethoxazole/trimethoprim. Environmental investigations revealed fecal contamination in two of four water sources. 

Conclusions: The findings suggest a waterborne cholera outbreak primarily driven by consumption of faecally contaminated river water. Cross-border population movement and gaps in contact tracing are plausible amplifying factors; however, direct epidemiological evidence for cross-border transmission was limited. The outbreak was contained within eight weeks through rapid response and effective case management. These findings inform cholera control strategies in border communities and highlight the need for strengthened cross-border surveillance and water safety interventions.

Background: Cholera outbreaks remain recurrent in Kenya, particularly in hotspot areas where environmental and socioeconomic vulnerabilities facilitate transmission. Timely transport of specimens from peripheral facilities to reference laboratories is essential for rapid outbreak response. However, cholera surveillance currently relies on reactive, ad hoc specimen transport arrangements that cause delays and operational inefficiencies. This study aimed to evaluate the cost-effectiveness of alternative cholera sample transport models and identify the most efficient and sustainable strategy to support outbreak response under the National Multisectoral Cholera Elimination Plan (NMCEP) 2022-2030.

Methods: A stratified cost-effectiveness analysis was conducted from a healthcare system perspective over a ten-year horizon across 107 hotspot sub-counties identified under the Priority Areas for Multisectoral Interventions (PAMI) 2024 report. Sub-counties were stratified by transport accessibility and logistical complexity. A decision tree representing the specimen referral pathway was linked to a two-state Markov model capturing outbreak recurrence. Four strategies were compared: the current ad hoc system, public–private partnerships (PPP), an integrated specimen referral system (ISRS), and dedicated transport. The primary outcome was cost per cholera sample successfully transported and accepted for testing within 24 hours. Sensitivity, equity and sustainability analyses were conducted.

Results: The ISRS ranked as the most cost-effective and sustainable strategy across cost-effectiveness ratios, incremental net monetary benefit, equity and sustainability analyses, dominating PPP, while dedicated transport achieved slightly higher effectiveness at substantially higher cost. Findings were consistent across all hotspot sub-counties, with the largest gains observed in remote, infrastructure-constrained settings. Sensitivity analysis confirmed the robustness of these findings. 

Conclusion: Integrated specimen referral systems provide a cost-effective, equitable and fiscally sustainable approach to strengthening cholera surveillance in Kenya. Prioritizing hard-to-reach areas and shifting from reactive transport to structured integrated referral systems can improve the timeliness of outbreak detection and response.

Background: Since 2012, Kenya has delivered consistent, high-coverage mass-treatment for soil-transmitted helminthiasis (STH) and schistosomiasis (SCH) to school-age-children across 27 counties through school-based deworming (SBD) strategy. From 2020, mass treatment was expanded to cover all risk groups through community-based deworming (CBD) strategy. Mapping and impact assessment data have been collected between 2020 and 2025 by both SBD and CBD programmes, covering the entire 47 counties of Kenya. This study collated and harmonized infection data for STH and SCH from the two programmes and fitted a model-based geostatistical (MBG) model to update the infection risk and treatment requirements in Kenya.

Methods: This modelling study utilised secondary data, which were assembled, cleaned, and used to fit MBG models. Infection diagnosis was performed using standard microscopic methods (Kato-Katz and urine filtration) as appropriate. A total of 18 covariates for the geostatistical models were fitted using three different methods: (i) Gaussian process (GP), (ii) Generalized linear model (GLM), and (iii) Stacked ensemble model (SEM). The fitted models were validated using a k-fold cross-validation approach. The models were fitted in an approximate Bayesian framework using mbg package (v1.1.0) in R (v4.3.2).

Results: The overall predicted prevalence was 4.46% (95% UI: 3.70-5.61) for any STH, with implementation unit (IU)-level prevalence ranging between 0.124% to 10.154%. For SCH, overall predicted prevalence was 3.43% (95% UI: 1.71-6.34), with sub-IU-level prevalence ranging from 0.006% to 16.020% for Schistosoma mansoni, and 2.40% (95% UI: 1.43-4.19), with sub-IU-level prevalence ranging from 0.025% to 37.840% for S. haematobium.

Conclusions: Given that 125/300 of the IUs and 498/1390 sub-IUs are currently predicted to be under surveillance, with many others requiring reduced treatment frequency, this indicates that many IUs and sub-IUs require an effective surveillance strategy. Further, the country requires rigorous assessment of elimination as public health problems for STH and SCH.

Background:
In 2023, Kenya revised its national immunization guidelines to incorporate catch-up vaccination for children who missed scheduled doses, aiming to close immunity gaps following the COVID-19 pandemic. However, limited operational evidence exists on integrating catch-up vaccination within routine primary health care systems. We evaluated the implementation of a routine catch-up vaccination model among children

Background

Healthcare workers (HCWs) are at increased risk of influenza exposure due to frequent patient contact making them a priority group for vaccination during influenza epidemics and pandemics. Strengthening HCW vaccination programs protects the essential health workforce and enhances readiness for future outbreaks. We assessed influenza vaccine uptake among HCWs to evaluate the feasibility of vaccination programs as a strategy for strengthening epidemic and pandemic preparedness.

 Methods

The project was implemented in Kakamega, Mombasa, Nakuru and Siaya counties in Kenya between 2023-2025. The implementation strategy included tiered sensitization and training at both national and subnational healthcare levels, complemented by the distribution of Information, Education and Communication (IEC) materials and continuous medical education sessions for HCWs. Seasonal influenza vaccine was offered annually to HCWs in public, private and faith-based health facilities. Vaccination was provided on-site by trained HCWs and recorded in both paper-based and electronic systems. A post vaccination survey assessed factors influencing vaccine acceptance.

 Results

High coverage was achieved across counties. In phase 1, vaccine coverage was highest in Siaya (94%; 4598/4882) and Nakuru (93%; 8776/9386) followed by Kakamega (90%; 6262/6995) and Mombasa (78%; 6746/8613). In phase 2, coverage remained high but slightly declined in Nakuru (85%; 9148/10714) and Kakamega (91%; 7085/7786), while remaining stable in Siaya (93%; 5243/5663) and Mombasa (78%; 7486/9654). A total of 27 adverse events following immunization were reported, all of which were minor. Among vaccinated HCWs 85% (639/748) cited self-protection as the primary motivation for vaccine uptake. Observed differences in coverage across counties suggest contextual influences including urban-rural differences and variation in vaccine acceptance across cadres.

 Conclusion

High influenza vaccine uptake among HCWs is achievable through leadership engagement, peer-led vaccination, and convenient on-site delivery. Our findings highlight scalable strategies for strengthening HCW vaccination programs and protecting essential health workforce during epidemics and pandemics.

Introduction: Drug-resistant tuberculosis (DR-TB) remains a major global health challenge, accounting for 13% of antimicrobial resistance deaths. Kenya, with a DR-TB prevalence of 1.5%, is among the 30 high-burden countries. In Makueni County, 132 DR-TB cases were reported between 2015 and 2024, yet more than half remained undiagnosed, signaling silent transmission.

Aim: The study aimed to develop and validate transmission dynamics and predictive models to identify patients at high risk of poor treatment outcomes.

Methods: A retrospective review of 132 DR-TB cases from the TIBU register was conducted in Makueni County. Patient-level sociodemographic and clinical data were analyzed using R. A SEIR model simulated transmission dynamics over 24 months, while machine learning models predicted treatment success. Model performance was assessed using sensitivity, specificity, accuracy, PPV, NPV, Cohen’s Kappa, and AUC.

Results: Most patients were male (73.5%) and aged 35–44 years (35.6%). Undernutrition was prevalent, with 60.6% underweight (BMI

Background:

Substance use disorders are a growing public health concern in Kenya, driving mental illness, hospital admissions, and societal burden. Mental health referral hospitals play a key role in detection, management, and monitoring. Laboratory toxicology provides essential evidence for accurate diagnosis, rational psychotropic use, and surveillance aligned with national health security priorities. Integrating toxicology into routine surveillance enhances patient safety, supports equitable evidence-based care, and advances UHC goals.

Objective:

To assess how laboratory toxicology services were integrated into mental health surveillance and contributed to health security at Mathari National Teaching and Referral Hospital.

Methods:

A retrospective review of routine laboratory toxicology testing was conducted between January 2025 to December 2025 among patients with suspected substance-induced mental disorders. All new patients from psychiatric outpatient department were tested before admission to the psychiatric wards, while patients on follow up psychiatric clinic visits were not included. A total of 3,977 specimens was analyzed using rapid qualitative toxicology screening method. Laboratory findings were compared with initial clinical assessments to evaluate their impact on diagnosis, treatment decisions, and institutional surveillance.

Results:

Laboratory toxicology testing confirmed substance involvement in 2468 of the tested cases, out of which 1548 patients tested positive for tetrahydrocannabinol (THC), 385 for Opiods (OPI), 412 for benzodiazepines (BZO), and 123 for tricyclic antidepressants (TCA). Toxicology results led to revision of initial clinical diagnoses in approximately one-third (799) of patients confirmed of substance abuse hence enabled more targeted clinical management. Laboratory toxicological confirmation enhanced patient safety by preventing drugs misuse and provided data to track substance trends among high-risk groups. By offering universal, evidence-based diagnostics, these services also advanced equity for vulnerable populations.

Conclusion:

Integrating laboratory toxicology into mental health surveillance enhances national health security by improving diagnostics, supporting evidence-based care, generating actionable data, and promoting equitable access.

Introduction:
Garissa County remains vulnerable to poliovirus transmission due to its proximity to Somalia, porous borders, high population mobility, and large refugee populations. On 14 May 2025, Poliovirus Type 2 (PV2) was isolated from a healthy community child in Ifo 2 Refugee Camp. 

Aim:
An investigation was undertaken to assess transmission risks, immunisation gaps, and the performance of surveillance systems. 

Methods:
We investigated the case from May 16th to 23rd, 2025. Activities included a detailed epidemiological and social assessment of the index case; a retrospective active case search for Acute Flaccid Paralysis and other vaccine-preventable diseases; a review of immunisation data; surveillance system assessment; and a survey of households within a 500-meter radius of the case. Detection of PV2 was achieved through routine surveillance of healthy children among new arrivals, targeting under-fives with fewer than three doses of oral polio vaccine. Virological analysis was conducted using standard WHO poliovirus isolation protocols at the national reference laboratory. 

Results:
PV2 was confirmed on 14th May, 2025, in a 36-month-old female. Between January and April 2025, 763 new arrivals were recorded across the Dadaab refugee camps, of whom 454 (61.2%) were zero-dose children. Refugee camp facilities reported OPV3 coverage above 80%, while host community facilities recorded suboptimal coverage (OPV3 as low as 57%). AFP surveillance indicators exceeded national targets, with no missed AFP cases identified. Key gaps included the absence of reception centres for new arrivals, documentation weaknesses, overstretched WASH services, and low caregiver literacy (78%), despite high immunisation acceptance.

Conclusion:
PV2 detection in a healthy child in Ifo 2 refugee camp highlights the persistent risks of poliovirus importation and transmission in refugee settings. Strengthening routine immunisation, quality of surveillance, WASH infrastructure, cross-border coordination, and establishment of reception and screening centres for new arrivals is critical to sustaining polio eradication efforts.

Background

Brucellosis, a zoonotic disease, requires integrated One Health initiatives involving animal, human and environmental health sectors. Humans acquire brucellosis through occupational exposure, consuming unpasteurized dairy products and contact with infected livestock. Despite the widely use of serological testing as a diagnostic tool, effective control includes coordinated laboratory surveillance, public health reporting and veterinary surveillance. Serological tests such as slide agglutination test may have limitations, including cross-reactivity & reduced specificity, highlighting the need for confirmatory testing. Limited integration of laboratory-confirmed human cases from private health facilities, into One Health surveillance systems may undermine early detection and management. 

Objectives

Assess laboratory-based brucellosis testing patterns and seroreactivity in a private Level II health facility and identify gaps in One Health surveillance. 

Methods

Retrospective review of laboratory data was conducted at a private Level II health facility in Nakuru between October 2024-September 2025. Extracted facility-based data included the number of brucellosis serological tests performed using Brucella antigen reagents (slide agglutination test), test results, patient age and sex.

Results

251 brucellosis tests were reviewed, of which 96 (38.2%) were reactive. Females accounted for 157 (62.5%), with 65 (41.4%) reactive results, while males accounted for 94 (37.5%) tests, with 31 (33%) reactive results. Testing was most frequent among adults aged 20-39 years. All reactive cases were managed clinically at the facility.  

Conclusion

Laboratory testing enabled detection and management of human brucellosis. However, One Health surveillance gaps were noted. Laboratory-detected cases were not systematically reported to public health authorities or linked to veterinary surveillance systems. The relatively high seroreactivity rate observed may reflect true exposure in high-risk population but could be influenced by limitations of serological testing, including false positives. Strengthening integration of private-sector laboratory data into public health and veterinary surveillance systems alongside access to confirmatory testing enhances zoonotic disease control within One Health framework.

Introduction

Manual, non-standardized procurement decisions in Kenyan health facilities often lead to misaligned supplies, creating bottlenecks that compromise service delivery. To address these challenges, inSupply Health and MOH-DHPT co-developed the Strategic Resource Management Tool (SMArT). This AI-powered, data-driven platform supports health facilities in prioritizing commodities for procurement to meet critical public health needs through evidence-based decision-making.

Aim 

To demonstrate how SMArT supported context-specific, adaptive commodity planning at a newly upgraded, specialized Mother and Child facility in Trans Nzoia, illustrating the tool's adaptability across facility levels, provided funding is available. The tool combined scientific prioritization with deliberate human judgment to align supplies with its specialized mandate.

Methods

The SMArT tool prioritized commodities using VEN/ABC frameworks alongside real-time stock-on-hand, workload, and forecast data. Unlike manual approaches, the tool automatically generated prioritized lists for review by county, sub-county, and facility teams, embedding human judgment directly into the workflow. This systematic algorithm ensured total order values aligned with available resources, reducing overstock and understock while maintaining an auditable trail of decision-making.

Results

Lacking historical data following its upgrade from Level 2, the facility utilized a comparable Level 4 facility as a workload benchmark. For Q3 2025, the facility faced a 69.3% funding gap, with KES 1.2 million available against a KES 3.9 million forecasted need. Given its specialized mandate, the tool assigned 100% priority to MNCH commodities, ensuring full critical supply coverage within the constrained budget, except where existing stock was sufficient.

Conclusion

The SMArT tool facilitates a shift toward evidence-based, responsive supply chain management. By generating recommendations that teams can interrogate and revise, the tool balances scientific prioritization with human judgment, ensuring facility needs are met even amidst severe financial constraints. This approach provides a replicable, innovative, data-driven model for achieving equitable access to health products and strengthening health systems across Kenya.